Provider Demographics
NPI:1003328535
Name:CRAIG, CHRIS (LMT)
Entity Type:Individual
Prefix:
First Name:CHRIS
Middle Name:
Last Name:CRAIG
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 WORTHY ST
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:TX
Mailing Address - Zip Code:76179-1351
Mailing Address - Country:US
Mailing Address - Phone:817-886-2700
Mailing Address - Fax:
Practice Address - Street 1:309 BYERS ST UNIT B
Practice Address - Street 2:
Practice Address - City:EULESS
Practice Address - State:TX
Practice Address - Zip Code:76039-3670
Practice Address - Country:US
Practice Address - Phone:817-886-2700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-24
Last Update Date:2017-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT123106225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist